The objective of infertility treatment should be the birth of a single, healthy child. Many of the treatment options presented to infertile couples, however, are associated with high risks of multiple gestations. Moreover, many couples view multiple gestations as desirable and are unaware of the risks they pose to both mother and babies. Couples should understand these potential risks before starting treatment.
The ability to limit the number of embryos or eggs transferred is an effective approach to limit multiple pregnancies. The Society for Assisted Reproductive Technology (SART) and the American Society for Reproductive Medicine (ASRM) have published guidelines recommending an optimal number of embryos for transfer based on patient age, embryo quality, and other criteria. In patients with favorable prognosis and good embryo quality, SART recommends consideration to transferring a single embryo to optimize the safety of mother and baby. Click here for ASRM’s recommendation on elective single embryo transfer.
In the United States, there is no federal or state law that regulates or addresses this subject. The decision regarding the number of embryos to transfer is made jointly by the physician and the patients. This decision should be based upon the best interests of the patient and the future offspring. However, ART is centrally regulated in England, and no more than three embryos may be transferred in most circumstances. In Canada, a recent Royal Commission recommended the transfer of a maximum of three embryos.